THBD and blood coagulation disease: Specifically, TXA has been thought to reduce mortality by preventing exsanguination on the day of injury.21 After significant trauma, coagulopathies may begin almost immediately and can rapidly progress to life-threatening scenarios.6–8 These coagulopathies have been postulated to be driven in part by excessive activation of the thrombomodulin-protein C pathway.22 Following tissue hypoperfusion in the setting of traumatic injury, protein C is activated.3 This subsequent rise in activated protein C leads to proteolytic cleavage and inactivation of procoagulant factors V and VIII.